I’m an oncologist. This is what King Charles and my cancer patients have in common

It’s best not to guess,” I said lightly. “People will tell you when they want.”

The next day King Charles announced to the whole world that he had gone into hospital for prostate surgery and emerged with a cancer diagnosis – one reason doctors should be loth to attach the prefix “routine” to any procedure. The details are sparse: his cancer is unspecified, he has begun treatment and retreated from public duties.

When Angelina Jolie revealed her deleterious genetic mutation, leading to the prophylactic removal of her breasts and ovaries, patients flocked in with their questions. Could they have the gene? How might they get tested? What did it mean for their offspring? Noting the ubiquitous headlines and “analysis” about the king’s diagnosis, I wondered how my patients would react. So far, not a word.

An official photo call picture of King Charles standing, with Swiss alps in the background, with William putting his arm around his father’s shoulder and smiling at a laughing Harry, seated to their right, all of them in ski jackets
Will the king’s cancer heal his feuding sons – or create a new schism?

For my patients, life continues to unfold in all its enormity and mundanity. Parking is hard to find, specialists even harder. Tracking appointments is a full-time job. Absorbing good news and swallowing bad news – and having the stomach for both at every visit – demands equanimity. Then, beyond the heavy logistics, there is the sheer emotional fatigue of carrying a diagnosis that everyone feels entitled to weigh in on.

I work in an area of stark socioeconomic disadvantage. Many of my patients are not just from the other side of the tracks, they may as well live on another planet. They lack language and money but, most of all, they lack agency. They are the sort of people who die waiting to figure out how to ask for help. My patients are as removed from royalty as you can imagine and yet I can’t help thinking that, in their core experiences, they might not be all that different.

The initial shock of a cancer diagnosis takes the wind out of everyone’s sails. What will I do now? Did I ignore the signs? What does my future hold? It doesn’t help that the usual narrative about cancer takes two forms: miracles and disasters. Either people defy the statistics or face an abject death. Of course, the truth lies in between: many cancer experiences have been transformed through modern medicine, agile technology and compassionate palliation. But surrounded by well-wishers, my patients describe feeling alone in the moment of discovery; they know that the weightiest implications will be theirs to negotiate in the silences between the noise.